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KPH HEALTHCARE SERVICES, INC · 2 weeks ago

Revenue Cycle Management Specialist - Collections

Oklahoma City, OK

Full-time

Onsite

Entry, Mid Level

1+ years exp

KPH Healthcare Services, Inc is focused on the healthcare industry, and they are seeking a Revenue Cycle Management Specialist - Collections to ensure timely collection of outstanding balances. The role involves managing the collection process, resolving denied claims, collaborating with internal teams, and ensuring compliance with laws and regulations.

Health CareMedicalPharmaceutical

Responsibilities

Manage the collection process for outstanding claims, including contacting insurance companies, patients, and other responsible parties via phone, email, and written correspondence

Investigate and resolve denied or partially paid claims, identifying root causes and implementing corrective actions

Collaborate with internal teams to address claims challenges and improve revenue cycle

Escalate complex or uncollectible accounts to management for further action

Submit appeals/claim corrections as needed within timely filing limits

Utilize billing software to maintain accurate and detailed records of all collection activities, including communication with payers and patients

Payer projects as assigned

Identify and report trends in claim denials and payment challenges

Communicate as needed with patients about billing issues , including the results of applications for financial hardship assistance and other responses to customer inquiries about

Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments

Assist in the implementation of processes to measure, assess, and improve the performance of the RCM department activities of the company

Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental

Participate in surveys conducted by authorized inspection

Participate in the company's Performance Improvement program as requested by the Performance Improvement

Participate in company committees when

Participate in in-service education programs provided by the company

Pursue continuing education programs appropriate to job

Perform other duties as assigned by

Complete all mandatory and regulatory training programs

Report any misconduct, suspicious or unethical activities to the Compliance

Complies with accepted professional standards and practice

Qualification

CPTHCPCSICD-10 codesHome infusion processMedical records interpretationPharmacy management systemsInsurance plan benefitsHIPAA complianceSelf-directedExcel proficiencyOutlook proficiencyAttention to detailVerbal communicationWritten communication